17 years on the job in Dallas, Officer Joe became Officer Debbie
By SHERRY JACOBSON / The Dallas Morning News
After 17 years with the Dallas Police Department, Officer Joseph Grabowski showed up at work one day sporting makeup, a feminine hairstyle and a new first name: Deborah.
The 44-year-old officer was scared and relieved that the secret was finally out.
“I have always felt like a woman and, suddenly, everybody knew I was going to have the surgery to make it real,” she said.
Because the city of Dallas does not offer health insurance coverage for sex-change operations, Grabowski paid for the costly procedure herself.
In recent years, a few cities – and a growing number of private employers – have decided to cover the cost of these surgeries, and the city of Fort Worth is considering whether to join them.
For a brief time in 2006, it was a minor curiosity that a Dallas policeman had become a policewoman. Co-workers had to learn to call Grabowski “Debbie” instead of “Joe.”
The public didn’t appear to notice, other than one woman who called to complain about a male officer wearing heavy makeup patrolling “in drag,” Grabowski recalled.
“We did everything we could to make Debbie comfortable, and I think we did a good job,” said Lt. Andy Harvey, a police department spokesman.
“There were no major issues. Joe was always a hard-working officer, and I think the same can be said of Debbie.”
In other ways, the transition from Joe to Debbie was not so easy.
With no insurance coverage for the sex change, technically called sex-reassignment surgery, Grabowski had to save for years to pay for the series of surgeries and other procedures that ultimately cost nearly $80,000.
Insurance coverage
In Fort Worth, sex-change insurance coverage for city employees was one of 20 recommendations presented this month by a city-sponsored diversity task force.
The effort was organized by City Manager Dale Fisseler in the wake of an improper raid at a downtown gay bar by local and state police.
Other recommendations called for better diversity training of city employees, family leave for domestic partners and broadening the city’s anti-discrimination ordinance to cover “gender identity.”
Perhaps the most controversial, however, was the idea of covering gender changes.
“It already brought a packed house to a City Council meeting,” said city spokesman Jason Lamers. “Some people didn’t like the idea of insurance coverage. But it wasn’t even on the agenda.”
Critics said the city is trying to give special privileges to a minority group.
The issue will be reviewed by Fort Worth’s health-benefits advisory committee to determine the financial implications, Lamers said.
“It’s not just the surgery they’ll look at,” he said, “but also the counseling and medication that go with this.”
Dallas says no
The city of Dallas does not cover sex-change procedures, said spokesman Frank Librio. Asked if the city would consider covering the surgery, he said, “We don’t cover it.”
A decision by Fort Worth is not likely until early next year.
“You hear opposition from those who don’t understand what it is. They think it’s just cosmetic surgery,” said Fort Worth lawyer Jon Nelson, a spokesman for a citizens group called Fairness Fort Worth, formed after the police raid.
Supporters of the expanded coverage are hoping the discussion will focus on how rarely these surgeries occur and how they are supported by the medical community.
“People have this idea that someone wakes up one day and says, ‘I’m a guy and I want to be a girl,’ ” Nelson said. “Actually, it’s a long and arduous process that is not substantially different than any other medically necessary surgery.”
People who seek a sex change are called transsexual, meaning they don’t accept the gender to which they were born, said Dr. Amy Altenhaus, a clinical psychologist who sees many such clients in her New Jersey practice.
“There’s a lot of confusion about this being a homosexual thing, but it’s not,” she said. “A transsexual is somebody who feels they are trapped in the wrong body. It’s not about sexuality, it’s about their identity. It’s who they are.”
Early knowledge
From her earliest memories, Grabowski said, she knew she wasn’t a boy.
“I dressed as a girl when I was very young,” she recalled. “My mother and my sister felt I would grow out of it. But I never did. When I got older, I would dress like a woman and wear makeup on the weekends, but I never went out.”
The American Psychological Association has labeled such behavior as “gender identity disorder” and estimates it occurs as often as 1 in 10,000 males and 1 in 30,000 females. The condition can cause emotional pain and suffering that leads to depression and even suicide.
Not everyone who identifies strongly with the opposite sex decides to undergo a sex change. Sometimes, it’s enough to have a supportive therapist or a few close friends who understand the truth.
“About half decide to do something about it,” Altenhaus said. “Expense is one reason, or there may be medical reasons not to do it.”
In a surprise move last year, the American Medical Association went on record opposing the apparent discrimination in health-insurance coverage for gender disorders.
The nation’s largest organization of physicians said it opposed “the categorical exclusion of coverage for treatment of gender identity disorder when prescribed by a physician.”
“If everybody had insurance coverage that made it possible to get these treatments, more people would do it,” said Jamison Green, a manager at the National Center of Excellence for Transgender Health, which is part of the University of California, San Francisco. The center, which opened last month, plans to develop protocols related to transgender health issues.
In San Francisco …
San Francisco was the first city to offer medical coverage for employees seeking gender changes. It changed its insurance plan in 2001, expecting to cover the cost of 35 sex changes a year. City workers had to pay an extra $1.70 a month for the benefit.
“With a large insurance pool, the cost of these procedures is minuscule, compared to the cost of treating anxiety and depression for transsexuals who can’t get the treatment they need,” said Green, who advised the city on its insurance change.
Within five years, San Francisco had amassed $5.6 million but paid out only $183,000 on 11 claims, leading the city to reduce and eventually eliminate the premium charge.
“Clearly, none of the fears have actualized,” the city’s Human Rights Commission noted of the concerns over the possible high cost of the procedures.
A basic sex change can cost from $10,000 to $100,000, depending on the type of surgery, the years of mental-health therapy and ongoing hormone treatment. About 1,000 Americans are believed to undergo gender transitions annually.
Long-held secret
The decision is not an easy one, said Grabowski, who kept her gender confusion secret for most of her life and pursued traditionally masculine activities.
In high school in upstate New York, it was competitive wrestling; in college, it was joining the military reserves.
Later, it was applying to both the police and fire departments in Dallas.
“I had no plans to go through sex-reassignment surgery because I didn’t know how the police department and my friends would take it,” Grabowski said. “And I didn’t know where to go anyway.”
Still, by living frugally, Grabowski saved $80,000 by 2005.
By then, the Internet was filled with information concerning sex-change surgeries available to people who could afford them.
It would cost $17,000 to $25,000 for genital reconstruction, plus $35,000 for cosmetic surgery that would “feminize” Grabowski’s facial features and a continual outlay of $200 to $400 a month for electrolysis to remove facial hair over a five-year period. There also was the cost of female hormones and ongoing mental-health therapy.
Grabowski did it all without regrets, understanding that the change from male to female would be permanent.
“To me, I was never a guy,” she said. “I’ve always been female. It was something my brain was hardwired to do at birth.”
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Comment by dglenn on 15 November 2009:
While I find the claim that the cost of covering SRS is “minuscule, compared to the cost of treating anxiety and depression for transsexuals who can’t get the treatment they need”, both credible and unsurprising, I’d be happier seeing numbers — estimates of the cost of treating closet-borne anxiety and depression. If the claim is accurate, quantifying it should make it stronger. (Estimating a dollar value for lost productivity due to the effects of that psychic burden, including suicides resulting from untreated gender dysphoria, would be more difficult, bu can only tip the scales farther in favour of providing SRS as an insurance benefit to those who need it.)
Hey, sometimes the kind thing to do is also the less expensive thing to do.
OTOH, some health insurance plans exclude even the treatment for anxiety and depression if it’s deemed to stem from GID, and that’s just plain evil. (Trans people don’t choose to be trans any more than cis people choose to be cis; we just get to choose what we do about already being trans.)
In any event, best wishes to Officer Debbie Grabowski.